Joining Medicare Advantage Plans, ask these Questions

Choosing between Medicare Supplement Plans 2018 and Medicare Advantage Plans is not a trivial matter to ignore.  Here are some of the questions that you must bear in mind before enrolling for Medicare Advantage plans:

 

Hospitals, Providers and other facilities queries to ask

  • Can I use my doctors with whom I am already referring? Are they listed in the network of the plan?
  • Will providers and doctors take new patients having this Medicare Advantage plans?
  • In case the Plans network does not have my providers, will the plan offer cover for my visits?
  • Which hospitals, specialists, skilled nursing facilities and home health agencies are in the network of the plan?

 

Approach to health care queries to ask

  • Name of the plan service area?
  • Will I receive coverage in case I receive care outside the service area?
  • Who will be my Primary care provider?
  • Is there a need for referral to see a specialist?
  • Is there a need for doctor’s approval to get admitted in a hospital?

 

Costs related queries to ask

  • What are the costs that I will receive as coverage?
  • The annual out of pocket maximum cost, how much is it?

 

Note: PPOs limits with out of pocket are different for in and out of network. In case of a PPO, you must ask the limits of out of pocket.

 

  • How much to pay as out of pocket prior to the starting of the coverage (what will be the deductible)?
  • How much will be my copayment for services on receiving regularly, such as specialist care or PCP?
  • How much to pay on visiting out-of-network facility or provider?
  • Does it include higher copays for certain care types, such as home health care or hospital stays?

 

Benefits relates queries to ask

  • Does my plan cover all that the Original Medicare services do not?
  • Dental services, hearing aids and vision care, are they covered?
  • Are there restrictions that I should know to access these benefits?
  • Prescription drugs cover, is it available with my plan?
  • Are my prescriptions as per the formulary of the plan?
  • Are there coverage restriction imposed on my plan?
  • What are the costs I must pay for drug coverage?
  • Will prescriptions be covered in my plan when I travel?
  • Can I use my pharmacy to get through mail order my drugs?